Abstract Details

Title Deep Phenotyping of Patients with Cognitive Impairment in HIV Infection

Topic Infections/AIDS/Prion Disease

Presentation(s) S38 - (-)

Poster/Presentation
Number 006

Objective

Background With the evolution of HIV associated neurocognitive disorders since the introduction of highly active anti-retroviral therapy, the classical pattern of subcortical dementia is evolving and involvement of other neural networks and patterns are being recognised. We hope that by understanding the pattern of cognitive impairment, we will be better able to understand the networks involved and hence the pathophysiology of HIV associated neurocognitive disorders.

Design/Methods This is a cross-sectional, prospective, observational study. Patients attending HIV outpatient clinics at our institution were offered cognitive screening using the Brief NeuroCognitive Screen and those with a positive screen were offered a detailed cognitive assessment. The neuropsychological tests used were the Montreal Cognitive Assessement (MOCA), Addenbrookes Cognitive Exam Revised (ACE-R), Frontal Assessment Battery (FAB) and the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). All patients had a detailed cognitive history and neurological examination carried out. Patient and disease characteristics were recorded.

Results 85 patients have participated in deep phenotyping. 50% of the patients had abnormalities in two or more domains on the RBANS when adjusted for age along with abnormalities on the ACE-R or the MOCA therefore meeting research criteria for the diagnosis of HIV associated neurocognitive disorder. The domains most commonly affected were immediate memory, verbal fluency and delayed memory. A significant number of patients also had visuospatial abnormalities. The most common finding on neurological examination was ideomotor apraxia.

Conclusions These findings may suggest a more amnestic, dysexecutive pattern of cognitive impairment although some patients exhibited abnormalities in attention more suggestive of the classically described subcortical impairment associated with HIV. This suggests that there are cortical features to cognitive impairment in HIV and this pattern may suggest an amnestic neurodegenerative syndrome.

Authors/Disclosures
Patricia McNamara, MD, PhD (National Hospital for Neurology and Neurosurgery) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Janice M. Redmond, MD	Dr. Redmond has nothing to disclose.
Colin Doherty, MD	The institution of Dr. Doherty has received research support from UCB pharma. The institution of Dr. Doherty has received research support from Science foundation Ireland.
David H. Margolin, MD, PhD (Genzyme Corporation)	Dr. Margolin has received personal compensation for serving as an employee of Cerevance, Inc. Dr. Margolin has received personal compensation in the range of $0-$499 for serving as a Consultant for Datacubed Health. Dr. Margolin has received stock or an ownership interest from Cerevance, Inc. Dr. Margolin has received stock or an ownership interest from Datacubed Health. Dr. Margolin has received intellectual property interests from a discovery or technology relating to health care.

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